Case report: patient with Weil's disease, chest pain, hepatitis b, hepatorenal syndrome, and electrolyte imbalance

1st International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) Faculty of Medicine Universitas Sumatera Utara

Mustopa^1 ; Susilo, R.S.B.^1 ; Arifin^1 ; Redhono, D.^1 ; Sumandjar, T.^1

Tropical Medicine and Infectious Diseases Sub Division, Department of Internal, Medicine Sebelas Maret University (UNS), Moewardi Hospital, Surakarta, Indonesia^1

关键词: Abdominal pain;    Chronic hepatitis b;    Electrolyte imbalance;    Gastrocnemius;    Laboratory test;    Liver disease;    Physical examinations;    Thrombocytopenia;   

Others  :  https://iopscience.iop.org/article/10.1088/1755-1315/125/1/012073/pdf
DOI  :  10.1088/1755-1315/125/1/012073

来源: IOP

【 摘 要 】

A 48-years-old man was hospitalized due to febrile for 5 days accompanied by headache and left chest pain radiating into the back. Pain calf, abdominal pain and tea color urine has occured since 1 week before admission. Physical examination revealed temperature 38.5° C, conjungtival suffusion, jaundice sclera, irregularheart sound, hepatomegaly, gastrocnemius tenderness, Faine score 23. Laboratory tests showed leukocytosis, thrombocytopenia, elevated transaminase enzyme, ureum 181 mg/dl, creatinine 4.3 mg/dl, albumin 2.4 g/dl, sodium 110 mmol/L, potassium 2.3 mmol/L, reactive HbsAg, CKMB 68.06 ng/ml, increased HBV-DNA, negative IgM anti Leptospira. MAT demonstrated 4 positive serovar. Electrocardiography revealed AF rapid ventrikel response. Chest x-ray showed cardiomegaly. Abdominal ultrasound revealed hepatomegaly with chronic parenchimal liver disease, renal insuficiency. Fibroscan showed severe fibrosis. Patient was diagnosed with Weil's disease and hepatorenal syndrome as complication. Patient was given clavulanate amoxicillin injections. This patient was not dialysis, only fluid balance monitoring and checked ureum-creatinine per 3 days, and there was improvement of ureum-creatinine. Hepatorenal syndrome in Weil's disease contributed to electrolyte imbalance. In addition, chronic hepatitis B on this patient was treated with tenofovir.